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Echocardiographic study of cardiac structure and function in people with bipolar disorder after midlife
Pao-Huan Chen1, Shuo-Ju Chiang2, Cheng-Yi Hsiao3
1Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan; Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Insights
Older adults with bipolar disorder (BD) show impaired heart function, including diastolic and systolic dysfunction. High body mass index may contribute to these cardiac issues in aging BD patients.
Area of Science:
- Cardiology
- Psychiatry
- Medical Imaging
Background:
- Heart failure is a primary cause of death in older individuals with bipolar disorder (BD).
- Research on cardiac structure and function in middle-aged BD patients using echocardiography is limited.
Purpose of the Study:
- To investigate cardiac structure and function in middle-aged and older adults with bipolar I disorder (BD-I).
- To compare cardiac parameters between BD-I patients and healthy controls.
Main Methods:
- 48 patients aged over 45 with BD-I underwent echocardiography and tissue speckle tracking.
- 31 healthy adults over 45 were selected as controls from an existing echocardiographic dataset.
Main Results:
- BD-I patients had significantly thicker interventricular septum and larger left ventricular internal diameter compared to controls.
- BD-I patients demonstrated reduced mitral valve E/A ratio and global longitudinal strain.
- Body mass index was negatively correlated with mitral valve E/A ratio in BD-I patients.
Conclusions:
- Aging patients with bipolar disorder exhibit diastolic and systolic cardiac dysfunction.
- Elevated body mass index may be a contributing factor to cardiac dysfunction in older BD patients.
Background:
Heart failure is the leading cause of mortality in older people with bipolar disorder (BD). Studies examining cardiac structure and function in middle-aged patients with BD by using echocardiography and cardiac strain imaging are scant.
Methods:
We recruited 48 patients with bipolar I disorder (BD-I) older than 45 years to undergo conventional and tissue speckle tracking echocardiography. Data of 31 mentally healthy adults older than 45 years were randomly retrieved from the echocardiographic dataset and compared with the data of BD patients.
Results:
Patients with BD-I had significantly higher mean values of interventricular septal thickness (Cohen's d = 0.83, p = 0.001) and left ventricular internal diameter (Cohen's d = 0.90, p = 0.001) at end-diastole relative to controls. Additionally, BD-I patients exhibited significantly lower mean values of mitral valve E/A ratio (Cohen's d = 0.67, p = 0.007) and a more reduced global longitudinal strain (Cohen's d = 0.72, p = 0.029) than controls. Multiple linear regression revealed that body mass index was negatively correlated with the mitral valve E/A ratio (adjustment R2 = 0.363, p = 0.043) in patients with BD-I.
Limitations:
A relatively small sample size may limit generalization.
Conclusions:
After midlife, BD patients exhibit cardiac diastolic (low mitral valve E/A ratio) and systolic (reduced global longitudinal strain) dysfunction. High body mass index may play a role in the unfavorable cardiac function in aging patients with BD.
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